Aims: Our purpose is to assess the role of cerebral small vessel disease (SVD) in prediction models in patients with different subtypes of acute ischemic stroke (AIS). Methods:We enrolled 398 small-vessel occlusion (SVO) and 175 large artery atherosclerosis (LAA) AIS patients. Functional outcomes were assessed using the modified Rankin Scale (mRS) at 90 days. MRI was performed to assess white matter hyperintensity (WMH), perivascular space (PVS), lacune, and cerebral microbleed (CMB). Logistic regression (LR) and machine learning (ML) were used to develop predictive models to assess the influences of SVD on the prognosis. Results:In the feature evaluation of SVO-AIS for different outcomes, the modified total SVD score (Gain: 0.38, 0.28) has the maximum weight, and periventricular WMH (Gain: 0.07, 0.09) was more important than deep WMH (Gain: 0.01, 0.01) in prognosis.In SVO-AIS, SVD performed better than regular clinical data, which is the opposite | 1025 WANG et al.

Background Small vessel disease (SVD) shares common vascular risk factors with large artery disease (LAD). However, little is known about the relationship between intracranial artery stenosis and SVD burden. Purpose To investigate whether SVD burden correlates with severity of intracranial LAD. Study Type Retrospective. Population Five hundred and sixteen patients with LAD of arterial circulation were enrolled from one hospital, including 384 males (59 ± 11 years) and 132 females (60 ± 12 years). Field Strength/Sequence 3 T. T1‐weighted fast spin echo (T1W FSE), T2W FSE, T2 fluid attenuated inversion recovery, diffusion‐weighted imaging, susceptibility‐weight imaging, and time‐of‐flight magnetic resonance angiography. Assessment The LAD was divided into mild stenosis (<30%), moderate stenosis (30%–69%), and severe stenosis (≥70%). The Standard for Reporting Vascular Changes on Neuroimaging criteria was used to rate the SVD burden according to the level of white matter hyperintensity (WMH), perivascular space (PVS), cerebral microbleed (CMB), and lacunes. Statistical Tests Lilliefors test, ANOVA, chi‐squared test, Mann–Whitney U test, Wilcoxon signed rank test, Bonferroni test, Spearman's correlation, logistic regression, and Cohen's kappa test. Results The grade scores for centrum semiovale PVS (CS‐PVS) were positively correlated with the degree of stenosis (R = 0.413), whereas the presence of severe basal ganglia PVS (BG‐PVS) was associated with CMB (R = 0.508), lacunes (R = 0.365), and severe WMH (R = 0.478). In multivariate analysis, severe CS‐PVS (adjusted odds ratio [aOR], 3.1; 95% confidence interval [CI], 1.9–4.8) and lacunes (aOR, 2.1; 95% CI, 1.3–3.4) were associated with severe stenosis of LAD. In addition, CS‐PVS was related to severe stenosis in a dose‐dependent manner: when CS‐PVS score was 3 and 4, the aORs of severe stenosis were 1.9 and 7.7, respectively. Data Conclusion The severity of LAD in anterior circulation is associated with SVD burden, which suggests that different SVD burden may be used for risk stratification in LAD. Evidence Level 3 Technical Efficacy Stage 3

Aim This study aimed to evaluate the diagnostic value of ultrahigh‐field magnetic resonance imaging (MRI) for brain tumors in clinical practice. Methods Thirty patients with brain tumors underwent 7‐ and 3‐T MRI. The performance and diagnostic confidence of 7‐ and 3‐T MRI in the visualization of tumor details such as internal structure and feeding artery were evaluated by radiologists. Contrast‐enhanced region performance and tumor detail diagnostic confidence score (DCS) were calculated and compared between 7 and 3T using Wilcoxon rank sum test. Results In 19 with obvious enhancement and 11 cases without obvious enhancement, 7‐ and 3‐T MRI showed similar performance. The tumors' internal structure and feeding artery were more clearly depicted by 7‐T MRI (62.2% and 54.4%, respectively) than by 3‐T MRI (2.2% and 6.7%, respectively). Furthermore, the mean DCSs of both internal structure and feeding artery were higher at 7T than at 3T (internal structure: 16.29 ± 9.67 vs. −5.79 ± 4.12, p = 0.028; feeding artery: 21.96 ± 6.93 vs. 4.46 ± 7.07, p = 0.028). The DCS was more significantly improved in the senior radiologist group. Conclusion Better visualization of brain tumor details and higher tumor detail diagnostic confidence can be obtained with 7‐T MRI.

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